John Inkster

John Inkster, who has died aged 87, was a pioneer in anaesthesia and intensive
care techniques that helped to make complex surgery safer for small babies.

5:58PM GMT 02 Nov 2011

In the 1950s it was often difficult to give artificial ventilation to newborns as the very small airways in their immature lungs tended to close up, preventing oxygen from being carried into the bloodstream. Inkster found when anaesthetising such tiny patients that if he introduced a small amount of resistance when the infant was breathing out, the lungs would not deflate fully, and thus the lower airways remained open for longer.

John Inkster

He presented these findings to the World Congress of Anaesthesia in 1968 and within months the technique, known as “positive end expiratory pressure” (or PEEP), was being used worldwide; its application was quickly extended to adults.

Today PEEP continues to play a vital part in the care of patients of all ages, and has even been extended to those – not uncommon – cases in which people stop breathing when they fall asleep (a condition known as sleep apnoea).

John Scott Inkster was born in Middlesbrough on August 12 1924, the second of twins. His father was a physician and the family originally came from Orkney. John was educated at Epsom College and qualified in Medicine at Aberdeen in 1946.

He became casualty officer at a small hospital in Hampstead, and was called upon to give general anaesthetics without any real training or supervision. This proved serendipitous, rather than catastrophic, as he immediately took to this branch of medicine and resolved to pursue it as a career.

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When called up for National Service in the Army, he duly asked to train as an anaesthetist, only to be told that he was needed as a regimental medical officer. Then, however, he had a serious motorcycle accident which left him unconscious for several days. Again, there was a surprisingly happy outcome: as he was considered not physically fit enough for regimental duties he was allowed to start training as an anaesthetist.

On leaving the Army he obtained a post in Newcastle with Professor Edgar Pask, one of Britain’s leading anaesthetists and a wartime innovator in the field. Inkster completed his training with visits to specialist units abroad, notably in Toronto, before being appointed a consultant in Newcastle in 1958, with a remit to develop services for children as well as adults.

So began a long career, during which he was frequently at the forefront of new developments. He formed a very strong working relationship with the Department of Medical Engineering at Newcastle University and, with Dieter Hoffman, invented the version for children of the so-called “Newcastle ventilator” – a machine developed by Pask to keep patients breathing during operations.

Inkster took particular pride in the case of the very last baby whom he anaesthetised. This was an infant with a huge liver tumour who had a very stormy operation – suffering much blood loss and many cardiac arrests. When asked by what technique he had managed to keep the desperately sick child alive, Inkster’s reply was that you have to “learn occasionally to fly by the seat of your pants”.

He was greatly gratified to receive follow-up reports and to hear in due course that the patient had graduated from university. Two days before Inkster’s death the young man completed a charity climb to the top of Mount Kilimanjaro in aid of a children’s cancer charity.

Another case, in the 1960s, attracted more publicity. Inkster, who was an active and enthusiastic member of his local TA field hospital, was on an annual training camp in Germany when the military hospital in Rinteln called to say that a baby had been born with no diaphragm and was dying.

As well as himself, Inkster’s TA unit happened to include a cardiothoracic surgeon, Hedley Brown, and was commanded by John Walton (now Lord Walton of Detchant), the future president of the British Medical Association. They were helicoptered across to help, but found themselves with nothing with which to repair the diaphragm. Then a nurse produced a silk slip which they duly sterilised and sewed into the baby, saving its life. Inkster always worked closely with nurses and recognised their vital contribution.

A short, slight man, blessed with great determination and a dry sense of humour, Inkster lectured around the world; he was also an early president of the Association of Paediatric Anaesthetists, which was formed in 1973. Very practical, he spent a period in retirement as volunteer handyman at a local hospice.

John Inkster married first, in 1947, Helen Milne Watt, with whom he had three daughters, of whom two were nurses and the third a radiographer. Following his wife’s death at the age of 57, he married, in 1982, Lynda Maybee, who predeceased him in 2000. His grandson is a consultant anaesthetist.